I have been working almost nonstop on scheduling my 4th year courses since we were given our "scheduling worksheets" a couple of weeks ago… and I have finally gotten my (preliminary) schedule signed off by my advisor and it is ready to be entered into the magic scheduling computer. 🙂  Which I could be doing right now if I had brought my instruction sheet with me today, but alas, it sits at home and I sit here in the hospital, and that’s life.

I am excited that I’m finally ready to be done wtih the thinking about the scheduling of the classes and things such as this (that sounds a lot like Arnold Schwarzenegger if you want it to…).   Then I just have to wait until March 28th to see if I actually got into any of the courses that I wanted.

Apparently I have to stay here (geriatric inpatient psychiatry unit – affectionately "geropsych") until about 4pm today since my resident has clinic and wants someone to "cover the unit" while he’s away.  The funny thing is that although I am here (along with another medical student), if anything actually happened I wouldn’t be able to (legally) make any decisions or write orders or anything.  So it just makes me laugh. 🙂

There were quite a few times that I wanted to take a minute and write about something I experienced this week, but I didn’t get the chance… so I’ll try to remember the thoughts and feelings now…

Monday
Have you ever had just a really great day?  That was Monday for me.  Everything at the hospital went really well, it was my last day with my attending and residents (end of the month, all would change the next day).  I got my mid-rotation evaluation which basically said I’m doing a great job and keep up the good work.  I gave my first ever tour to a group of med school applicants and it went really well… and I got Amighetti’s for lunch (really good deli sandwiches).  I met with my advisor about planning my fourth year courses and applying to residency and he told me that with my test scores, grades, and clinical evaluations, I will be a very competitive applicant to any residency program of my choosing (including UW… and Stanford, and Oakland Children’s).  This was a great day.

Tuesday
Have you ever had just a really bad day?  Yeah, that was my Tuesday.  Maybe I should have expected that after such a great Monday something like this would happen.  Like I said before, this was the first day of a new month, so all my attendings and residents changed.  I showed up at a time that would have been early for my previous attending, earlier than I have ever gotten to the hospital for this rotation, but the attending and resident were already rounding at 6:30am!  (This is compared to rounding at 8 or 9am with my previous attending).  Realizing that I had missed half of morning rounds got my day off to a bad start.  Then this attending was just really gruff and abrupt, such a change from the last one… I just felt rushed all day, then my resident tells me that I (and the other student) are in charge of all the new admissions (of which there were 5 total for the day… that’s a lot by the way!) and we’re to do the admission H&P’s (History & Physical) as well as the admit orders.  Well, this is totally NOT in the realm of student responsibilities – at least not for us to do alone, so I just got overwhelmed and frustrated – and it was a good thing I had scheduled Buffy night over at Jill’s for this night – I definitely needed it.

Thursday
I got to go to my continuity clinic today!!  🙂 Big smiles!  Because that’s the pediatrics clinic!  Oh it was so nice to just be working with kids again for the afternoon.  Yep – definitely going to go into peds.

Friday
This day wasn’t so bad – I had to get up at o’dark-thirty to get AJ to the airport in time to catch his flight back to Seattle – but then I was feeling so gross that I just called in sick to the hospital and went back to bed.  So most of the day was a wash since I slept it away, but when I woke up later in the afternoon I felt so much better.  I think maybe the stress of the week was just getting to me.

Hmm – not as exciting to read about my week in little sound bites as it was to actually live it.  I guess it will have to do though.  This weekend has been really nice.  I’ve been very productive with studying and creating my fourth year schedule and researching options for doing some away rotations (at UW and in Portland).  I also got a whole lot of laundry and dishes done, and all the garbage taken out.  That kind of stuff feels really good sometimes.  And the weather has been so nice – warm and balmy all weekend – so I’ve been taking long walks around the neighborhood with some of my study books – so I get to walk and study at the same time.  I’ve had a really nice break this weekend and I’m not extremely excited to start back at the hospital tomorrow, but I think it’ll all work out just fine.

So here’s the thing – there are a lot of people out there who have no idea what it takes to finally become a fully licensed and practicing physician – I am doing my best to remedy this with a nice little explanation page about that particular topic.  Look over there to the right… see where it says "Dr. Jill – The Journey" under "Pages"?  Well, you can click on that for a nice (though a tad bit lengthy) explanation.  Please let me know if anything is unclear so I can try to update it with a better explanation.

It has been too long since I’ve written anything.  Right now I am sitting in the conference room over on 2 West – the Inpatient Geriatric Psychiatry Unit – where I am currently finishing up week one out of six for my Psychiatry rotation.  I was really scared to start here… because of it being pyschiatry, because of it being geriatrics… I didn’t know what to expect.  But I have been pleasantly surprised by my experiences here.  The patients, though obviously in need of some kind of assistance (otherwise they wouldn’t be in the hospital) have all been realtively easy to interact with and very open to talking to me.  I feel like I am helping, even if it’s just by being a listening ear – which may be one of the more effective ways for me to help.

I would write more, but I have to get ready to present my patients at Attending Rounds.  I’ll try to get some more thoughts down over the rest of this weekend.  Oh, and I want to get my Valentine’s Day pictures up soon – A.J. and I had a -shaped pizza for dinner! 🙂

and that is something I’ve been realizing over and over again: I have to do things for myself – for my own reasons, so I will be content – and not just to make other people happy. The case in point right now is my little journey into obstetrics and toying with the possibility of changing career plans. My biggest drive for considering the change and for seriously thinking about OB/GYN was that someone else thought it would be a good idea. And that someone was very persistent, and very complimentary, and telling her that I was considering OB made her happy – which in turn made me happy. So the thought of actually becoming an OB/GYN doctor was never really something that sparked a fire under me. But the thought of someone liking me, encouraging me, being happy because of something I was doing – that did spark a fire. 🙂 Today I’m going to my continuity clinic at Cardinal Glennon – and I will tell you that seeing all the kids there and being their "doctor", that really gets me and that is really what I want to do. Even if I do have a knack for surgery, being in the OR doesn’t excite me, not enough to make a career out of it. It’s just hard to tell that to someone who obviously is excited by the OR… This entry is a bit discombobulated, sorry for that. I’ve got my OB/GYN final exam next week then I move on to Psych (and hopefully a little more sleep). I am tired.

If anyone is paying attention to the timestamp on this entry, you’ll notice that it is just past 3AM here in St. Louis as I sit in the resident’s room on the St. John’s Mercy Medical Center Labor and Delivery Unit. I am nearly done with my week of nights here (working 7pm to 7am) and it has been…hmm.. what is the appropriate adjective to finish this sentence?

Awesome? It has definitely been that – I’ve seen vaginal births, cesarean births, emergency cesareans, twin births… I’ve gotten to deliver a placenta and co-deliver a baby. It has definitely been awesome.

Exhausting? That it has been as well. Working nights throws off everything about my internal schedule. All I do is work and sleep – because once I get home (by about 8-8:30am) I have to go straight to bed to get my 7-8 hours of sleep before I get up and head right back to the hospital. When I’m working days I can at least watch some TV… have a meal… spend some time with AJ… or at least relax a little before I sleep, but I just can’t find the time to do that right now. At least I only have 1 more night after this one.

Confusing? A little, yes. I really like OB and one of the chief residents here is laying it on thick about how good I would be as an OB – how I really "get" the surgery aspects and how she thinks I would excel in something surgical. I haven’t given up my pediatrics ambitions (and I don’t think I will), but this is the first rotation that has given me a reason to stop and think about what I want to do with my life as a doctor. The residency is longer, the hours would be worse… but would I like it more?

Anyway – tonight has been pretty slow, giving me time to catch up on reading and try to study a little for a quiz I have in the morning (read: at the end of this 12 hour shift when I have to go back to school – without sleeping first – and take a quiz and attend 4 hours of lecture). I will be sad when my 2 weeks on labor and delivery is over, but it will be nice to sleep again. 🙂

Grades available in medical school: Fail, Pass, Near Honors, Honors

Grades I received (finally) for the first half of my third year of medical school: Honors, Honors, Honors (that would be for Surgery, Pediatrics, and Neurology).

I didn’t totally expect that, but I’m also not totally surprised, since I did have bits and pieces of my grades earlier… but it’s such a relief to finally have some closure on those rotations – I finished Surgery way back in August and just finally got my grade yesterday! That sure motivates me to work hard this half of the year – I’m on a roll!

And now my Peds Shelf exam is complete, bringing to a close my 8 wonderful weeks of Pediatrics. I still found the shelf to be a bit difficult, but definitely not as bad as Surgery was – and I ended up with a great score for that, so who knows how this one will turn out.

I’ve spent this weekend cleaning, organizing, doing laundry and dishes – basically all the everyday things that get pushed to the side while I’m enmeshed in a rotation and have presentations, studying, and exam worries on my mind. I really enjoyed getting the apartment all spruced up and weeding through the closet again. It amazes me how I can always find a few more items of clothing to donate everytime I sift through my wardrobe.

I start on Neurology tomorrow – still at Cardinal Glennon so I’m still with kids (which is so great). I’m looking forward to seeing the world of child neurology – but a little nervous about how I’ll handle a 4 week rotation. I’ll have to be studying right from the beginning – not take so many lazy days as I allowed myself duirng the longer rotations. I’m not too worried though.

My big toes both still have a little purple nail polish left on them – a little bit of mom right here in St. Louis. 🙂

Whew – big sigh of relief… my Peds oral exam is finally over. I have been stressing about it for the past coule of weeks (as everyone around me can attest to) but it came and went with barely a nervous jitter – much ado about nothing, I suppose. I had one of the Chief Residents as my examiner, and she was very laid back and easy to chat with. She made it more of a conversation than an exam. Now all I have to do is get through the multiple-choice shelf exam on Friday – then a whole free weekend!!! Whoopee!

I really wish I would have taken the time to write a bit earlier on in the rotation.. but a few memories will have to do:
1. The calm that washes over me as I sit rocking in the well-baby nursery holding a new life that is barely 12 hours old. The way that hours pass in the blink of an eye as I stare at the new babies and wonder just how much of this world they can even see, and what their little minds must be thinking.
2. Stickers and tiny waves are the best way to a child’s trust and cooperation – that and “finding” things in their ears with the otoscope.
3. It doesn’t matter how early I get to the hospital, I will always have enough work to fill my time until rounds begin.
4. I love smiling kids. I love crying kids. That’s how I know peds is for me.